Obesity Rate Levels Off in Most States

Obesity rates remained steady in every state except one in the last year, halting a 3-decade trend of near universal increases, according to a report from the Trust for America's Health (TFAH) and the Robert Wood Johnson Foundation (RWJF).

"In talking about this year's report, we considered renaming it F as in Forward because we honestly believe real and lasting progress is being made in the nation's effort to turn back the obesity epidemic," Risa Lavizzo-Mourey, MD, president of the RWJF, and Jeffrey Levi, PhD, executive director of the TFAH, wrote in a letter to open the report.

Despite that good news, obesity rates remain very high. Today, 13 states have adult obesity rates above 30%, and 41 states top 25%. Arkansas, the one state that saw a significant increase, went from an obesity rate of 30.9% to 34.5%.

In 1980, no state was above 15%, and in 1991, no state was above 20%, according to the report. More than two-thirds (68.7%) of American adults are either obese or overweight.

Also, in most places where childhood obesity rates have dropped, children in low-income communities and minorities are experiencing slower reductions in obesity, the authors said.

"If we fail to reverse our nation's obesity epidemic, the current generation of young people may be the first in American history to live sicker and die younger than their parents' generation," Lavizzo-Mourey and Levi said.

There have been signs the nation is making progress in curbing obesity trends.

For example, some diverse states like California and Mississippi have reported progress in reducing rates of childhood obesity. That's after major cities like Philadelphia and New York have made preventing obesity a priority.

The same F as in Fat report in 2005 found increases in obesity rates in 49 states. That number fell to 37 in 2008, 28 in 2010, and 16 in 2011.

The stagnant rates "probably reflect genetic phenotypes and perhaps some change in caloric density of food choices and physical activity," George Blackburn, MD, PhD, of the Harvard Medical School division of nutrition, in Boston, told MedPage Today.

"We must ensure that policies at every level support healthy choices, and we must focus investments on prevention," he added.

David Katz, MD, MPH, director of the Yale University Prevention Research Center, questioned if society is hitting the limit on obesity rates. He compared obesity to smoking, saying a number of people will continue to smoke despite efforts to stop it and evidence of its negative effects on health.

"A leveling off of obesity rates would be inevitable when we hit the ceiling. The question is: Is the ceiling at or below 100%?" Katz told MedPage Today in an email. "It may be that just as some fixed percentage is resistant to everything we do to discourage smoking, a small but fixed percentage is resistant to everything modern culture does to encourage obesity. Maybe we are pushing up against that threshold."

Other findings from the report include:

Rates vary by region, with the 20 states having the highest percentages of obesity and overweight all located in the South or Midwest

Rates vary by age, with obesity rates for Baby Boomers (45- to 64-year olds), having reached 30% in 41 states, but exceeding 30% in one state -- Louisiana -- for seniors (65 years old or older)

Obesity rates are now nearly the same for men (35.8%) and women (35.5%) despite a nearly 6-percentage-point difference a decade ago (men: 27.5%, women: 33.4%)

Almost a third of adults with incomes less than $25,000 a year were obese compared with a quarter of those who earn less than $50,000 a year

More than 35% of those ages 26 and older who didn't graduate from high school were obese, compared with 21.3% of those who graduated from college or technical school

Lavizzo-Mourey and Levi said the country can learn from success already learned to make further gains in reducing obesity such as changing public policies, community environments, and general promotion of healthy eating and physical activity.

"We must build a movement around a truly comprehensive approach to making our nation healthier, citizen by citizen, town by town, state by state," they said.

Data from the report come from the Behavioral Risk Factor Surveillance System, an annual telephone survey of more than 400,000 adults.

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